Provider Demographics
NPI:1629225057
Name:WOLFF, BRIAN C (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:WOLFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1909
Mailing Address - Country:US
Mailing Address - Phone:303-500-3407
Mailing Address - Fax:303-835-4500
Practice Address - Street 1:3345 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1909
Practice Address - Country:US
Practice Address - Phone:303-500-3407
Practice Address - Fax:303-835-4500
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY-3578103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35971860Medicaid